As the Employee Advocate here at Acadia Benefits, I get several calls each month from our customers who are unsure of how a claim for “routine lab work” was processed. Because their doctor ordered this lab work as part of their routine physical, many people assume the lab work will be covered in full, similar to how the actual physical is covered.
However, many insurance plans are set up to follow guidelines under the Affordable Care Act. Those guidelines state that not all lab work is automatically covered in full. There is a listing available at the following website: https://www.healthcare.gov/preventive-care-adults/.
As we can see, the lab work on this list is limited. Therefore, if your doctor tells you they are ordering routine blood work as part of your annual physical, be prepared to possibly receive a bill for these services, as they will most likely be applied to the plan’s deductible.